Pattern, Precipitants and Short Term Outcome of Heart Failure Patients Managed at Federal Medical Centre Nguru, a Tertiary Health Centre in Yobe State Northeastern Nigeria

Abstract

Heart Failure (HF) is a syndrome characterized by typical symptoms (e.g. breathlessness, ankle swelling and fatigue) that may be accompanied by signs (e.g. elevated jugular venous pressure, pulmonary crackles and peripheral oedema) caused by a structural and/or functional cardiac abnormality, resulting in a reduced cardiac output and/or elevated intracardiac pressures at rest or during stress. Clinical studies investigating the aetiological patterns of heart failure in Sub-Saharan Africa (SSA) revealed that hypertension, cardiomyopathy and rheumatic heart disease account for more than two-thirds of cardiac disease cases. The objective of this study therefore is to assess the pattern, precipitating factors and short term outcome of heart failure among patients admitted into our hospital. Method: The study was a prospective cross-sectional type conducted among in patients with heart failure in the medical ward of the hospital. Results: A total of three and fifty four (354) subjects were recruited into the study, comprising one hundred and twenty nine males (36.4%) and two hundred and twenty five (63.4%) females. Majority of the patients were admitted in NYHA functional class IV. This however improved to class II at discharge though few were discharged in NYHA class III. Heart failure secondary to progressive hypertensive heart disease was the most common (39.0%) followed by peripartum cardiomyopathy (22.6%) while idiopathic dilated cardiomyopathy (11.0%) and rheumatic heart disease (7.3%) were the third and fourth causes of heart failure respectively. The most common precipitating factor for heart failure in this study was chest infection (44.9%). In conclusion, the study revealed that progressive hypertensive heart disease was the leading cause of heart failure, followed by peripartum cardiomyopathy while idiopathic dilated cardiomyopathy and rheumatic heart disease were ranked third and fourth causes of heart failure respectively. Though myocardial infarction is on the increase, it was found to be the fifth cause of heart failure. The study also identified the following precipitants of heart failure in decreasing order of occurrence: chest infection, non-adherence to prescription, and urinary tract infection.